Outcomes of pancreas retransplantation in patients with pancreas graft failure. BJS 2018; 105: 1816-1824.
Published: 14th July 2018
Authors: S. Gasteiger, B. Cardini, G. Göbel, R. Oberhuber, F. Messner, T. Resch et al.
Pancreas retransplantation is still a controversial option after loss of a pancreatic graft. This article describes the experience of pancreas retransplantation at a high‐volume centre.
This was a retrospective observational study of all pancreas retransplantations performed in a single centre between 1997 and 2013. Pancreatic graft loss was defined by the return to insulin dependence. Risk factors for graft loss as well as patient and graft survival were analysed using logistic and time‐to‐event regression models.
Of 409 pancreas transplantations undertaken, 52 (12·7 per cent) were identified as pancreas retransplantations. After a median follow‐up of 65·0 (range 0·8–174·3) months, 1‐ and 5‐year graft survival rates were 79 and 69 per cent respectively, and 1‐ and 5‐year patient survival rates were 96 and 89 per cent. During the entire follow‐up, 22 grafts (42 per cent) were lost. Patient survival was not associated with any of the donor‐ or recipient‐related factors investigated. Five‐year graft survival was better after simultaneous kidney–pancreas retransplantation than pancreas retransplantation alone: 80 per cent (16 of 20) versus 63 per cent (20 of 32) (P = 0·226). Acute rejection (odds ratio 4·49, 95 per cent c.i. 1·59 to 12·68; P = 0·005) and early surgical complications (OR 3·29, 1·09 to 9·99, P = 0·035) were identified as factors with an independent negative effect on graft survival.
Pancreas retransplantation may be considered for patients whose previous graft has failed.Full text
You may also be interested in
Clinical value of additional resection of a margin‐positive distal bile duct in perihilar cholangiocarcinoma.
Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Mizuno, T. Tsukahara, Y. Shimoyama et al.
Authors: W. S. Tummers, J. V. Groen, B. G. Sibinga Mulder, A. Farina‐Sarasqueta, J. Morreau, H. Putter et al.
Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation.
Authors: J. Kirkegård, E. K. Aahlin, M. Al‐Saiddi, S. O. Bratlie, M. Coolsen, R. J. de Haas et al.
Authors: R. G. Hanna‐Sawires, J. V. Groen, F. A. Klok, R. A. E. M. Tollenaar, W. E. Mesker, R. J. Swijnenburg et al.
Authors: T. Mizuno, T. Ebata, Y. Yokoyama, T. Igami, J. Yamaguchi, S. Onoe et al.
Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer. BJS 2019; 106: 342-354.
Authors: M. Strijker, J. W. Chen, T. H. Mungroop, N. B. Jamieson, C. H. van Eijck, E. W. Steyerberg et al.
Randomized clinical trial
Randomized trial of oral versus enteral feeding for patients with postoperative pancreatic fistula after pancreatoduodenectomy. BJS 2019; 106: 190-198.
Authors: J.‐M. Wu, T.‐C. Kuo, H.‐A. Chen, C.‐H. Wu, S.‐R. Lai, C.‐Y. Yang et al.
Clinical and experimental studies of intraperitoneal lipolysis and the development of clinically relevant pancreatic fistula after pancreatic surgery.
Authors: Y. Uchida, T. Masui, K. Nakano, A. Yogo, A. Sato, K. Nagai et al.
Multicentre propensity score‐matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases.
Authors: M. J. van der Poel, L. Barkhatov, D. Fuks, G. Berardi, F. Cipriani, A. Aljaiuossi et al.
Authors: T. M. Mackay, U. F. Wellner, L. B. van Rijssen, T. F. Stoop, O. R. Busch, B. Groot Koerkamp et al.
Proposal for a new classification for perihilar cholangiocarcinoma based on tumour depth. BJS 2019; 106: 427-435.
Authors: K. Shinohara, T. Ebata, Y. Shimoyama, M. Nakaguro, T. Mizuno, K. Matsuo et al.
Systematic review of the quantity and quality of randomized clinical trials in pancreatic surgery. BJS 2019; 106: 23-31.
Authors: F. J. Hüttner, L. Capdeville, F. Pianka, A. Ulrich, T. Hackert, M. W. Büchler et al.